The Case for Medication-Assisted Therapy for Opioid Use Disorder

Note: This is the second article in a series on substance abuse disorders and the issues surrounding treatment. The goal of this series to educate and inform so we can better support our clients and our communities through the opioid epidemic.

Addiction is now recognized as a chronic brain disease that affects the way a person thinks and perceives the world, and all too often results in compulsive substance abuse despite the harm it causes. But research has shown that opioid use disorder is a medical condition that can be treated effectively with a combination of medication, behavioral therapy and counseling services known as medication-assisted treatment (MAT). The medication is used to reduce the withdrawal symptoms and cravings so that the patient can stay focused on recovery using the other services in the program.

Approximately 80%–90% of those who need treatment for substance abuse disorders do not receive services, and MAT programs can be hard to find. (Currently only opioid and alcohol use disorders can be treated with MAT; the FDA has yet to approve any medications to treat methamphetamine, marijuana, or cocaine addictions.) One issue is that not enough physicians have been trained in how to treat patients using MAT. Also, the medications used to treat opioid use disorder—naltrexone (Vivitrol), buprenorphine (Suboxone) and methadone—are controlled substances, which means the programs that dispense them must be federally certified, another hurdle for patients seeking treatment programs. But treatment specialists note that the situation may be changing for the better. The federal government recently approved the use of buprenorphine for treatment in physician offices rather than only in special clinics, so that patients can receive treatment in a familiar setting in their community. The government also increased the limit on the number of buprenorphine patients a qualified physician is allowed to treat. These changes should make it easier for patients to find MAT programs.

A common misunderstanding of MAT is that the treatment just substitutes one addiction for another. However, research shows that when provided at the correct dose, the medications used in MAT do not lower a person’s intelligence, mental capability, or ability to function. In fact, MAT has been shown to improve many aspects of a patient’s well-being, from increasing patient lifespan to increasing the ability to get and/or keep a job. At the same time, MAT helps patients decrease their use of illegal drugs and other criminal activity and lowers their risk of contracting and spreading communicable diseases such as HIV and hepatitis C. When delivered properly and paired with other support services, medication-assisted treatment increases the likelihood that a patient can get and stay clean and build a healthier life.